Provider Demographics
NPI:1407058837
Name:RITSCHARD, DANIEL W (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:RITSCHARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 BARBER DR.
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623
Mailing Address - Country:US
Mailing Address - Phone:970-274-8461
Mailing Address - Fax:
Practice Address - Street 1:1378 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1840
Practice Address - Country:US
Practice Address - Phone:970-963-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9303174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist